Community hospitals nationwide may be looking to Baptist Medical Center South,
Jacksonville, Fla., for a peek into the future of high-tech medical care.

The 92-bed, 248,000-square-foot facility, part of the Baptist Health system,
opened Feb. 16 as a fully digital community hospital. Patient information is
contained on electronic medical records and physicians order tests and medications
electronically. The results of such tests as x-rays and computed tomography
scans are also stored on computers.

Operations are running smoothly, says Roland Garcia, senior vice president
and chief information officer for Baptist Health. “There is a sense of
calm—busy, but calm,” throughout the hospital, Garcia says.

That may be because physicians agree to use the electronic system when they
apply for hospital privileges. Then they go through training to learn how to
use the new technology before they begin practicing at the hospital. More than
450 physicians have already been credentialed for Baptist South and the hospital
is recruiting aggressively. About 240 physicians cared for patients during the
hospital’s first eight weeks of operation. Nurses and other staff also
went through an extensive training process.

On opening day and for about two-and-a-half weeks afterward, about 100 information
technology staff members were available in three shifts around the clock to
troubleshoot and answer questions. The number of IT personnel on call has dropped
significantly since then, Garcia says, as employees have become more familiar
with the new systems.

Our goal, Garcia adds, is to provide better care more safely and more quickly.
To this end, the hospital plans to introduce telecommunication technology in
the operating room. Through a video camera and computer link, surgeons will
be able to consult in real-time with pathologists in the laboratory.

“The pathologist in the lab can look at exactly what the surgeon is seeing,”
potentially before the sample gets to the lab, says David Foreman, a spokesman
for Baptist Health. “If there’s something on a slide, it can be
called up [via the computer], and both can be looking at it and talking about
the same thing.”

The new technology added to the hospital’s price tag, about $84 million,
but not as much as might be expected, notes Garcia, because some of the technology
was already deployed at other Baptist Health facilities in the Jacksonville
area. The digital equipment, on the other hand, was more expensive. For example,
a digital mammography machine costs about two-and-a-half times as much as a
regular machine. Garcia says the hospital hopes to recoup such costs in several
ways, but mainly by eliminating redundancy, such as duplicate tests, and streamlining
the patient care process. “If I can get a nurse to devote one more hour
of her shift to patient care as opposed to paper shuffling, that adds up,”
Garcia says.

In addition to affording an opportunity to build an all-digital facility from
the ground up, the new hospital also offered Baptist Health the chance to link
together into one system the various components of its electronic medical record
used at its other hospitals. These included emergency department, dietary, and
pharmacy applications, the picture archiving communication system, and other
ancillary applications under the architectural umbrella of the Cerner Millennium
system.

Physicians at Baptist Medical Center South can connect to the EMR via desktop
computers at workstations, carts with wireless computers, or mobile devices,
such as tablets from Panasonic, Hewlett-Packard, or Jujitsu, which are stored
in cabinets that must be unlocked with name badges. Other solutions providers
include Phillips and GE Healthcare, while some of the hardware came from large
manufacturers, including Dell Computer.

The hospital will soon benefit from such technology as direct interfaces between
patient monitors, and the EMR will eliminate manual entry of such information
as a patient’s temperature, heart rate, and other vital signs, Garcia
says.
The new systems will also offer additional intelligence capabilities that, Garcia
says, will be implemented as physicians adjust to the current setup. “It’s
not the end game, yet,” he notes.

Coalition pushes for single standard for patient information
exchange

The HIMSS Electronic Health Record Vendors Association, a coalition of electronic
health record vendors, in May published a white paper that endorses adopting
a single universal standard for exchanging patient information.

The association proposed using a single XML schema and syntax, a content model
defined and vetted by health professionals who use the content in their clinical
practices, and extensibility to other document types and discrete data. The
association also proposed implementing standardized integration profiles based
on those developed by Integrating the Healthcare Enterprise, an initiative established
by health care professionals.

To ensure that vendors comply with an adopted standard, the EHRVA also recommends
that they be certified by the independent Certification Commission for Healthcare
Information Technology. According to the EHRVA, this commission should be chartered
to establish criteria for certifying electronic health record products, including
defining the requirements for functionality and interoperability.

Health care providers should ask their information system vendors how and when
they plan to implement interoperability standards. Simply having an HL7 interface
is not enough.

Orchard upgrades Harvest LIS

Orchard Software recently released Orchard Harvest LIS version 6.5.

Many new features have been added to version 6.5 to meet the demands of small
to medium-sized hospitals. Among the new features are flexible printing and
faxing options for automatic result delivery; the ability to schedule automatic,
unattended runs of the data browsers; the ability to configure microbiology
to bill automatically; configuration options, saved criteria, and filtering
options for existing reports; and the ability to configure system security to
lock user accounts after a specified number of unsuccessful sign-in attempts.

Medical Automation Systems acquires Epsilon Group

Medical Automation Systems’ wholly owned subsidiary, TEG Virginia LLC,
has acquired the assets of the Epsilon Group. The new company will conduct business
under the Epsilon name.

The Epsilon Group will now offer Medical Automation Systems’ information
management products for point-of-care testing, including MAS’s RALS (remote
automated laboratory systems) solution, with its customized scientific research
and consulting services.

Doctors Company endorses interactive electronic health record

The Doctors Company has endorsed the physician-patient communications network
iHealth Record, which debuted online last month.

Medem’s iHealthRecord (www.ihealthrecord.org)
is a secure, interactive electronic health record that houses personal health
data for physicians and emergency departments and provides patients with education
programs specific to their medical conditions, automated reminders pertaining
to medications and conditions, access to secure physician-patient online communications,
and FDA-related safety warnings and recalls.

The Doctors Company is a leading physician-owned medical malpractice insurance
provider.

Contracts

Wray (Colo.) Community Hospital has contracted with Optio Software for its
QuickRecord and MedEx electronic health record and forms management solutions.

The University of South Alabama Health System, Mobile, has signed a $1.2 million
agreement to purchase the Misys Laboratory comprehensive information management
solution suite. The health system purchased the Misys laboratory, blood bank,
and microbiology modules, CoPathPlus, and expanded outreach functions.

Yale-New Haven (Conn.) Hospital has signed a contract to license Mediware’s
transfusion software system to manage its transfusion services.

Dr. Aller is director of bioterrorism preparedness and response for Los Angeles
County Public Health Acute Communicable Diseases. He can be reached at raller@ladhs.org.
Hal Weiner is president of Weiner Consult ing Services, LLC, Florence, Ore. He
can be reached at hal@weinerconsulting.com.
Dr. Weilert is di rec tor of laboratories, Community Hospitals of Central California,
Fresno. He can be reached at mweilertmd@communitymedical.org.